Nursing Elites

1. A client is diagnosed with somatic symptom disorder. Which of the following behaviors should the nurse expect?

• A. Excessive worry about physical symptoms
• B. Fear of gaining weight
• C. Frequent visits to healthcare providers
• D. Persistent depressive mood

Correct answer: C

Rationale: Individuals with somatic symptom disorder often exhibit frequent visits to healthcare providers due to their excessive worry about physical symptoms. They seek reassurance and explanations for their perceived medical issues, even when there is no organic basis for their complaints. This behavior is a characteristic feature of somatic symptom disorder and distinguishes it from other conditions. Choices A, B, and D are incorrect. Excessive worry about physical symptoms may occur but it is not the primary behavior associated with this disorder. Fear of gaining weight is more characteristic of eating disorders, and persistent depressive mood is more indicative of mood disorders rather than somatic symptom disorder.

2. A healthcare professional is caring for a patient with bipolar disorder who is experiencing a manic episode. Which intervention is most appropriate?

• A. Encourage group activities to increase socialization.
• B. Provide a structured environment with limited stimuli.
• C. Allow the patient to engage in physical activities freely.
• D. Give the patient detailed and complex tasks to complete.

Correct answer: B

Rationale: During a manic episode, individuals with bipolar disorder may have heightened sensitivity to stimuli and may struggle with organization and decision-making. Providing a structured environment with limited stimuli can help reduce triggers and maintain a sense of control for the patient. It is essential to create a calm and predictable setting to support the individual in managing their symptoms effectively. Choice A is incorrect as group activities may overwhelm the patient due to increased stimuli. Choice C is not the most appropriate because unstructured physical activities may exacerbate the manic symptoms. Choice D is not recommended as detailed and complex tasks can be overwhelming and may contribute to increased stress and agitation in a manic episode.

3. When assessing a client's behavior for potential aggression, what behavior would be recognized as the highest predictor of future violence?

• A. Pacing and restlessness
• B. Verbal threats
• C. History of violence
• D. Substance abuse

Correct answer: C

Rationale: A history of violence is considered the highest predictor of future violence. Clients who have a history of violent behavior are more likely to engage in violent acts in the future compared to those who exhibit other behaviors such as pacing, making verbal threats, or having substance abuse issues. Understanding a client's history of violence is crucial in assessing the risk of potential aggression and violence. Pacing and restlessness, verbal threats, and substance abuse can be concerning behaviors but do not carry the same predictive value for future violence as a documented history of violent behavior.

4. Research conducted by Miller and Rahe in 1997 demonstrated a correlation between the effects of life changes and illness, leading to the development of the Recent Life Changes Questionnaire (RLCQ). Which principle most limits the effectiveness of this tool?

• A. Specific illnesses are not identified.
• B. The numerical values associated with specific life events are randomly assigned.
• C. Stress is viewed as only a physiological response.
• D. Personal perception of the event is excluded.

Correct answer: D

Rationale: The main limitation of the Recent Life Changes Questionnaire (RLCQ) is that it does not consider an individual's personal perception of a life event. As people may interpret events differently, their subjective perspective plays a crucial role in how they experience stress and its potential impact on their health. Ignoring personal perception limits the effectiveness of the tool as it fails to capture the variations in how people respond to life changes. Choices A, B, and C are not the main limitations of the RLCQ. Specific illnesses not being identified or numerical values being randomly assigned do not directly impact the personal perception of life events. Additionally, viewing stress as only a physiological response is not the primary limitation, as stress encompasses psychological and emotional components as well.

5. During a treatment team meeting, the point is made that a client with schizophrenia has recovered from the acute psychosis but continues to demonstrate apathy, avolition, and blunted affect. The nurse who relates these symptoms to serotonin excess will suggest that the client receive?

• A. Chlorpromazine
• B. Phenelzine
• C. Haloperidol
• D. Olanzapine

Correct answer: D

Rationale: In this scenario, the symptoms of apathy, avolition, and blunted affect are indicative of negative symptoms commonly seen in schizophrenia. These symptoms are often associated with dopamine and serotonin imbalances in the brain. Olanzapine, an atypical antipsychotic, is known for its efficacy in treating both positive and negative symptoms of schizophrenia. It acts by blocking serotonin and dopamine receptors, helping to alleviate the symptoms mentioned. Chlorpromazine and Haloperidol are typical antipsychotics that primarily target dopamine receptors, while Phenelzine is an MAOI used to treat depression and anxiety disorders, not schizophrenia. Therefore, the most appropriate choice for this client displaying these symptoms related to serotonin excess would be Olanzapine.

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